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Commissioners ‘failing’ to consider wider societal issues

Survey shows majority of CCGs make procurement decisions on cost basis alone

Mark Gould

Friday, 26 May 2017

Only a small minority of Clinical Commission Groups (CCGs) are considering the social, economic and environmental benefits of their procurement and commissioning decisions.

The Public Services (Social Value) Act 2012 requires commissioners to consider these broader benefits when making commissioning decisions. The Act came in response to concerns that competitive tendering focusing solely on cost at the expense of other forms of value. The legislation enables CCGs to commission providers who are smaller and community based, and/or are engaged in social enterprise or not-for-profit activities.

But research conducted by National Voices, a coalition of health and social care charities, and Social Enterprise UK, the umbrella body that represents not-for-profit organisations, found that only 13% of (CCGs) can clearly show that they are actively committed to pursuing social value in their procurement and commissioning decisions.

Freedom of Information requests were submitted to all CCGs in England (209 at the time) and received responses from 91% (191). The research is the first comprehensive study into the use of the Social Value Act in the healthcare system.

The researchers found that:

  • 43% of respondents either had no policy on the Act; were not aware of a policy; or had a policy in some stage of development.
  • Just 25 CCGs (13%) demonstrated what the authors define as ‘highly committed, evidenced and active’ use of the Act.
  • Weighting procurement for social value, even amongst the most highly committed CCGs, is limited and low. A pass/fail question or a weighting of 2% of the total evaluation was common.
  • Analysis of Sustainability and Transformation Plans found that just 13% mention social value.

The report authors warn that improved commitment to social value is vital to achieving the Five Year Forward View aim of creating a "new relationship with people and communities" and NHS plans to move to more place-based "accountable care systems". The report also highlights that adequate consideration of broader social value when making commissioning decisions is vital to ensuring that the public pound is used as effectively as possible.

It says that social value should be built into NHS England’s Right Care programme which assists CCGs with commissioning value-based patient pathways. And the report calls for NHS England, the Department of Health and Public Health England to issue joint guidance on implementation of the Social Value Act. The authors conclude that there must be closer working between the voluntary sector and NHS organisations to deliver greater social value.

Don Redding, the director of policy at National Voices and joint author of the report, said: “The Social Value Act enables commissioners creatively to shape local non-statutory provision, so as to support people and communities with prevention, managing their health and achieving wellbeing. This approach is inherent in the Five Year Forward View, the new care models and the general move towards more place-based and population-focused ‘accountable care systems’.

“The NHS needs a serious review of how it supports commissioners to have the knowledge, confidence and skills to adopt social value these principles and approaches.”

Peter Holbrook, chief executive of Social Enterprise UK said the research confirms anecdotal reports that the Act is being underused by the NHS. "In this way, CCGs are lagging behind local authorities and housing associations in seizing the opportunity that the Act provides.

“The healthcare system needs to tap into the reach and knowledge of the social sector, to join up across services and agencies, and to maximise the value from each pound spent. The Social Value Act can help with each of these."

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